Αξιολόγηση της ποιότητας ζωής ασθενών με νεφρολιθίαση κατά τη διάρκεια της θεραπείας με διαδοχική τοποθέτηση ουρητηρικού Double-J stent
Assessment of quality of life in patients with nephrolithiasis during treatment with sequential Double-J ureteral stent placement
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Keywords
Νεφρολιθίαση ; Ουρητηρικός καθετήρας Double-J ; Ποιότητα ζωής ; USSQ ; EQ-5D-3L ; Ουρητηροσκόπηση ; Ενδοσκοπική λιθοτριψίαAbstract
Background: Nephrolithiasis is one of the most common urological diseases and has a considerable impact on patients' health-related quality of life. Double-J (DJ) ureteral stent placement is a widely used intervention to ensure urinary drainage and prevent complications; however, it is frequently associated with urinary symptoms, pain, and impaired daily functioning.
Objective: The aim of the present study was to evaluate longitudinal changes in the quality of life of patients with nephrolithiasis undergoing ureteroscopy and sequential Double-J ureteral stent placement, and to investigate quality-of-life changes throughout the treatment pathway.
Methods: A prospective multicenter study was conducted in three military hospitals in Greece. Twenty patients with nephrolithiasis who underwent ureteroscopy and sequential placement of two Double-J ureteral stents were enrolled. Quality of life was assessed at four time points: one week after the first stent insertion (T1), four weeks after the first insertion (T2), one week after ureteroscopy with endoscopic lithotripsy and second ureteral stent insertion (T3), and four weeks after removal of the second stent (T4). Health-related quality of life was evaluated using the Ureteral Stent Symptom Questionnaire (USSQ) and the EQ-5D-3L, including the EQ Visual Analogue Scale (EQ-VAS). Statistical analysis was performed using the Friedman test and Wilcoxon signed-rank test.
Results: A statistically significant improvement in quality of life was observed throughout the treatment course. The greatest impairment was recorded following the initial ureteral stent placement, followed by a progressive improvement in overall USSQ scores and EQ-5D-3L and EQ-VAS outcomes. Contrary to the initial hypothesis, the second ureteral stent placement was not associated with deterioration in quality of life but rather with further improvement in most outcome measures. The most pronounced improvement was observed following removal of the second stent.
Conclusions: Quality of life changes significantly during the management of patients with nephrolithiasis. The gradual resolution of urinary symptoms and pain leads to substantial improvement in patients' overall well-being, while repeat ureteral stent placement following ureteroscopy does not appear to negatively affect quality of life. The combined use of disease-specific and generic patient-reported outcome measures provides a comprehensive assessment of patients' experiences and may contribute to more patient-centered clinical care.